New Ways to Improve the Patient Experience: Because it Begins Before the Front Door

“New Ways to Improve the Patient Experience: Because It Begins Before the Front Door”

TraceCommunication.com

“New Ways to Improve the Patient Experience: Because It Begins Before

the Front Door”

Patti Consolver, Senior Director of Patient AccessScott Phillips, Senior Director of Patient Access

Texas Health Resources

TraceCommunication.comProprietary and Confidential ©2014 The White Stone Group, Inc.

Today’s Webinar Agenda

• Housekeeping Items• Introduction of Speakers and Presentation• Q&A Session

TraceCommunication.comProprietary and Confidential ©2014 The White Stone Group, Inc.

Housekeeping Items

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Webinar Playback

• Today’s presentation will be recorded.• View past recordings on our website:

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Asking Questions

• Submit questions at any time using Q&A box in the bottom right hand panel

• Questions will be addressed at the end of the presentation

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Today’s Presenters

Patti Consolver, CHAMSenior Director, Patient Access

Texas Health Resources

Scott Phillips, CHAMSenior Director, Patient Access

Texas Health Resources

“New Ways to Improve the Patient Experience: Because It Begins Before

the Front Door”

Patti Consolver, Senior Director of Patient AccessScott Phillips, Senior Director of Patient Access

About THR

Includes more than 20,500 employees working in 24 acute-care and short-stay hospitals that are owned, operated, joint-ventured or affiliated with THR

Texas Health is one of the nation’s largest faith-based, nonprofit health care delivery systems.

About THR

Serves 16 counties in the Dallas-Fort Worth area of north central Texas, home to more than 6.2 million people

Learning Objectives

1. Consolidate pre-service communications to a single touch point to reduce confusion, duplication and inconvenience for patients.

2. Identify common patient complaints with pre-service activities and update processes to resolve the issues.

3. Record conversations in pre-service areas for a complete picture of the patient’s experience from first encounter to the point of admission and beyond.

Today’s Agenda

• Review THR’s patient experience strategy• Describe the role patient access plays in the overall

patient experience• Consider the benefits of a centralized model for

patient access services• Review industry best practices for patient financial

communications• Describe challenges that drove THR’s need for change• Review the process we implemented • Review benefits realized and lessons learned

Our Patient Experience Journey

• Goals & progress• Key players• Role of Patient Access

Patient Access Model

Schegistration

• Centralizing pre-registration and insurance verification

• Eliminate redundancies by partnering scheduling & pre-registration processes– Reduce number of calls to the patient– Optimize flow for patients by reducing duplication– Eliminate rescheduling/cancellations

Schegistration

• Streamline patient access to the system to improve the overall experience– Schedulers conduct a warm transfer to the Patient

Access Intake Center (PAIC) to complete call– Documentation standardization – including

authorization, scheduling and registration info

Challenges Faced

• Patient complaints often led to he-said, she-said scenarios

• Inability to determine root cause • Lack of standardized training for staff on how

to resolve the issues• Effectiveness of handoff between scheduling

and PAIC

Our Journey• 2002: Began recording insurance verification phone calls

– Established proof of patient coverage for reimbursement• 2007: Opened Patient Access Intake Center

– Centralized insurance verification and pre-registration activities

• 2009: Began recording phone calls with patients at the point of scheduling and pre-registration– Expanded from system already used to record authorization phone calls

with payers• 2012: Began recording in-person conversations with patients at

registration– Entire patient access experience is recorded. (Scheduling, Pre-

registration, Verification, Face-to-Face at Registration.)

Recording Patient Interactions

• Step 1: Scheduling– Record patient and/or physician phone call– Capture faxed physician order– Document patient information– Screen for risk• Right procedure• Right order• Right physician

Recording Patient Interactions

• Step 1: Scheduling• Step 2: Pre-Registration– Patient demographics– Benefits and eligibility– Self-pay estimates– Scheduling instructions– Directions

Recording Patient Interactions

• Step 1: Scheduling• Step 2: Pre-Registration• Step 3: Insurance Verification– Correct authorization– Correct status– Confirm for appeals

Recording Patient Interactions

• Step 1: Scheduling• Step 2: Pre-Registration• Step 3: Insurance Verification• Step 4: Face-to-face at Registration– POS collections– Financial counseling– Bedside registration in ED

Recording Patient Interactions

• Step 1: Scheduling• Step 2: Pre-Registration• Step 3: Insurance Verification• Step 4: Face-to-face at registration• Step 5: Indexing and retrieval

Indexing and Retrieval

• Index recordings to patient account• Establish audit trail for every encounter• Complete picture of a patient’s pre-service

experience – from the initial encounter at scheduling to the point of admission

Process Improvements

• Identification of common indicators– Asked for the same information – address, phone

number, etc. – multiple times– Told wrong location for a procedure– Given inaccurate instructions– Told different copay during different conversations

Process Improvements

• Identification of common indicators• Service recovery– Responding to negative surveys– Addressing patient complaints– Identifying risk opportunities– Identifying training opportunities

Process Improvements

• Identification of common indicators• Service recovery• Staff training– Proactive monitoring: 10 recordings/month– Identifying outliers– Conducting employee evaluations– Providing 1-to-1 training– Self-training; replaying interactions

Process Improvements

• Identification of common indicators• Service recovery• Staff training• Drilling down– Eg., Compare length of admission encounter for

pre-registered vs. walk-in patient– Eliminate duplication to optimize flow for patients

THR Pilot Project

• Leadership Retreat: How can we improve?• Pilot project– Make a change– Test and monitor impact– Roll out across organization

• Eg., recording of mammography patient’s registration experience; what we learned

Next Steps at THR

• Further implementation of best practices• Expand on pilot project• Implement quality scoring tool– Measures– Scorecards– Reports

Quality Scorecards

Reports by Criteria

Scorecards by Department

Process Overview

Scheduling

Communication management system records & indexes the calls/conversations

If there is ever a complaint, administration can review the patient’s entire experience to

identify the problems

The recordings also provide a valuable training tool for

allowing staff members to hear their own mistakes

Texas Health is able to drive new initiatives that improve patient satisfaction

Pre-Registration Insurance Face-to-Face

Patient Financial Communications

Release of new industry-wide best practices for improving and standardizing how healthcare organizations

communicate with patients about financial issues

Best practices developed by group representing healthcare organizations, physicians, payers, and patient advocates

Healthcare organizations have the opportunity to achieve adopter recognition to demonstrate core commitment to

best practices

Best Practices Released Oct. 2013

Best Practices

“These common-sense best practices bring consistency, clarity, and transparency to patient financial communications, and outline steps to help patients understand the cost of services they receive, their insurance coverage, and their individual responsibility.”

Patient Financial Communications

Patient Financial Communications

Emergency Department

Time of Service (Outside the ED)

Advance of Service

All Settings

Measurement Criteria

5 Key Areas:

Time of Service

Pre-Registration Discussions

Maintain a thread of registration, insurance verification and financial counseling discussions

If these discussions took place during pre-registration, no need to repeat

All Settings

Incorporate compassion, patient advocacy and education in all patient discussions

Use standard language to guide staff in common types of discussions

Resolve issues face-to-face when able

Conclusion

• The experience begins before the front door• Benefits of a centralized model• Patient financial communication best practices• Recording provides valuable insight for change• Monitoring and measuring impact of change

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Questions?

Please submit questions using the Q&A section in the participant panel.

TraceCommunication.comProprietary and Confidential ©2014 The White Stone Group, Inc.

Thank you!

Blair [email protected]

The White Stone Group, Inc.

Patti [email protected]

Texas Health Resources

Scott [email protected] Health Resources